Key result
Diabetic autonomic neuropathy linked to ~81% higher paroxysmal AF recurrence versus diabetes without neuropathy.
Why the study?
There are no data about the occurrence of paroxysmal atrial fibrillation in the population with diabetic autonomic neuropathy.
Does diabetic autonomic neuropathy increase P-wave duration, dispersion, and atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation?
Observational (n=100)
No
Does diabetic autonomic neuropathy increase P-wave duration, dispersion, and atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation?
Absolute Event Rate: 47% vs 26%
p-value: p=<0.01
Diabetic autonomic neuropathy is associated with increased P-wave duration and dispersion, and a higher recurrence rate of paroxysmal atrial fibrillation.
May prompt closer AF monitoring in diabetics with neuropathy; hypothesis-generating and should not yet change practice.
INTRODUCTION: Atrial fibrillation (AF) is the most common sustained arrhythmia. Diabetic autonomic neuropathy (DAN) is a frequent complication of diabetes mellitus and has a negative impact on the cardiovascular system. There are no data about the occurrence of paroxysmal atrial fibrillation (PAF) in the population with DAN. MATERIAL AND METHODS: We analysed the data of 100 patients with PAF. The study population was divided into three groups: group I: 28 patients with diabetes mellitus (DM) and DAN, group II: 34 patients with DM without DAN, and group III: 38 patients without DM. P-wave duration (FPD) and dispersion (PWD) were measured during sinus rhythm and AF episodes were counted during 12 months of follow-up. RESULTS: Recurrence of PAF was higher in group I (47 episodes/year) compared to groups II and III (26 and 22 episodes/year) - p<0.01. The FPD was longer in group I (137.4 ±12.0 ms vs. 126 ±23.0 ms in II group and 129 ±18.3 ms in group III; p<0.001). The PWD was longer in patients with DAN (53 ±19 ms vs. 36 ±18 ms and 34 ± 20 ms, p<0.001). CONCLUSIONS: The results showed that the presence of DAN caused a significant increase in P-wave duration and dispersion, which might be responsible for the recurrence of AF.
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Bissinger et al. (2011) conducted an observational in Paroxysmal Atrial Fibrillation and Diabetes Mellitus (n=100). Diabetic autonomic neuropathy vs. Diabetes mellitus without autonomic neuropathy and patients without diabetes was evaluated on Recurrence of paroxysmal atrial fibrillation (episodes/year) (p=<0.01). The presence of diabetic autonomic neuropathy was associated with a significantly higher recurrence of paroxysmal atrial fibrillation (47 episodes/year) compared to diabetic patients without neuropathy (26 episodes/year) and non-diabetic patients (22 episodes/year).
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